OBJECTIVE: To investigate whether either the condition of being unemployed, or changes in unemployment rates are associated with suicide risk. DESIGN: Administrative data for suicide according to occupational status have been analysed considering three employment categories: employed, seeking new job (unemployed), seeking first job (never employed). Comparison of suicide rates by economic position and correlation between suicide and unemployment rates have been made. SUBJECTS AND SETTINGS: 20,457 deaths by suicide registered in Italy among economically active people from 1982 to 1994. MAIN OUTCOME MEASURES: Change over time in suicide rates by economic position; coefficient of aggravation according to occupational status. RESULTS: Suicide rates among the unemployed are clearly and constantly higher than those among the employed: up to three times higher among men, and twice as high among women. Among the unemployed a clear and significant rise in suicide rates in both sexes took place over the study period; suicide rates among the employed showed a less marked increase. The rise in suicide rates was accompanied by a concurrent rise in unemployment rate percentage. Men seem to be affected most by this change in unemployment rate percentage; women are subject to less evident influences and variations. CONCLUSION: Different suicidal behaviour trends among unemployed compared with employed people indicate that unemployment (and above all the prospect of not having access to a working role) acts as a contributing factor for suicide. Unemployment, even if symptomatic of a mental disorder, should therefore always be taken into consideration as a risk factor for suicide: the potentially lethal consequences of its negative influence on both self esteem and the ability to use supportive networks in a efficient way is an element to which great attention should be paid.
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